Bharat Raval

Perforation of the Colon Due to Endometriosis

Endometriosis is a common disease which affects the bowel in 12 to 35% of cases. Despite extensive serosal and intramural involvement, the intestinal mucosa usually remains intact and bowel perforation rarely occurs. We describe a patient with perforation of the sigmoid colon due to endometriosis. To our knowledge, this is the first such case to be reported in the radiologic literature.

Computed tomography of complicated cholecystitis

Reported are 10 patients with surgically verified acute cholecystitis and its complications. Of these 10 patients, 6 (60%) had atypical clinical presentation so that cholecystitis was not the primary diagnosis being considered before computed tomography. Common computed tomography findings included gallbladder wall thickening (100%), pericholecystic fluid (80%), gallstones (50%), and air in the gallbladder lumen and wall (20%). An awareness of the computed tomography appearances can be helpful in the diagnosis of complicated cholecystitis even when the clinical presentation is atypical.

An unusual presentation of mediastinal hodgkin's lymphoma on computed tomography

Untreated mediastinal Hodgkins lymphoma may present with calcification within the tumor mass. Therefore, Hodgkins lymphoma should be included among the possible diagnoses of calcification in an anterior mediastinal mass, as visible on chest CT or mediastinal tomography.

CT diagnosis of perforated duodenal diverticulum

We present a case of perforated duodenal diverticulum diagnosed preoperatively on computed tomography. This rare but potentially fatal condition has been difficult to detect with more conventional radiographic techniques.

Computed tomography in detection of occult hypernephroma

Five cases in which computed tomography (CT) detected a hypernephroma that had been missed by one or more of the other imaging modalities are reported here. Computed tomography may have an important role in the diagnosis of radiologically occult hypernephroma.

CT appearance of long-term renal transplant rejection

Computed tomography in a patient with long-term renal transplant rejection demonstrated diffuse renal calcification and perirenal abscess that were subsequently confirmed pathologically. Calcification in the rejected transplant kidney has not been documented by CT before. Computed tomography of the pelvis was done to visualize the status of the renal transplant and to elicit the nature of the swelling. On CT, there were areas of curvilinear and punctate calcifications (Figure 1A) in the kidney and an inflammatory mass around the transplanted kidney, mostly on the inferior and lateral aspects. A collection of fluid approximately 3 cm in diameter, with a CT density of + 1.3 units ( 500 air I + 500 bone), was seen arising from the lower pole of the calcified kidney (Figure 1B). A diagnosis of diffuse calcification in a rejected transplant kidney and an abscess arising from a rejected transplanted kidney was made. Causes of diffuse renal cortical calcification include renal cortical necrosis, chronic glomerulonephritis, and rejected renal transplants, as recently reported (1). Only 2 cases of diffuse cortical calcification of rejected renal transplants have been reported in the literature; the CT finding of calcification in a rejected renal transplant has not been previously reported. A plain film of the pelvis barely revealed the renal calcification, and linear tomography showed faint calcification in a shrunken transplanted kidney (Figure 2).

Spontaneous necrosis and hemorrhage in an enlarged accessory spleen: CT demonstration.

Enlargement of an accessory spleen following splenectomy may be due to compensatory hypertrophy or recurrence of hematologic or other disorders. Spontaneous necrosis and hemorrhage in an accessory spleen are rarely described. We report a case in which an enlarged accessory spleen complicated by spontaneous hemorrhage was identified on computed tomography (CT) and confirmed at surgery.

Use of computed tomography in appendicitis: Technique, findings, and pitfalls

Twelve patients with acute appendicitis were studied by computed tomography. Our technique of conducting the examination, the computed tomography signs, and the pitfalls encountered in studying these patients are presented. Use of computed tomography should be considered whenever the clinical presentation is atypical or confirmation of the clinical diagnosis is necessary.

CT Appearance of Adrenal Myelolipoma

Abstract Myelolipoma of the adrenal gland is a rare benign tumor. On review of the literature, there are only 3 reported cases of proven adrenal myelolipoma who had CT examinations (1–3). We would like to report this fourth case to confirm the value of CT. Our case was unsuspected and the diagnosis was made by CT.

Spontaneous free perforation of the ileum in Crohn disease : CT demonstration

A case of spontaneous free perforation of the ileum in Crohn disease is presented. This rare complication was demonstrated by computed tomography (CT) before becoming evident on plain films.